Provider Demographics
NPI:1366293300
Name:BRUNA, DANIELA OLIVO (MD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:OLIVO
Last Name:BRUNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:LUCAS OLIVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:28062 BAXTER ROAD, GRADUATE MEDICAL EDUCATION OFFICE
Mailing Address - Street 2:
Mailing Address - City:MURRRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563
Mailing Address - Country:US
Mailing Address - Phone:345-619-8858
Mailing Address - Fax:
Practice Address - Street 1:28062 BAXTER ROAD, GRADUATE MEDICAL EDUCATION OFFICE
Practice Address - Street 2:
Practice Address - City:MURRRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563
Practice Address - Country:US
Practice Address - Phone:345-619-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program